ࡱ> o@ Cbjbj p p (ooC{6666666J>>>>D>JG2????????ƘȘȘȘȘȘȘ$yR˜J6A??AA66??PPPA* 6?6?ƘPAƘPPP66?? 'S>>GNn4Ƙ0GL PjhJJ66666?Z?@P<@4p@???JJd=>wPJJ>Compare and contrast the de-Angelis technique and the tibial Wedge Osteotomy as treatments for anterior cruciate ligament ruptures in the dog. Both are surgical treatments that produce extracapsular stabilization The De angelis technique consists of: Lateral retinacular stabilization and the lateral imbircation The de Angelis Estracapsular is the most common procedure. It mimics the direction of ACL Anchors around the lateral fabella and tibial crest Monofilament non absorbable 2-0, to 0 are used a less expensive material is leader line which just can be autoclaved once. Post operative care of the De Angelis encompasses: Bandage 5 7 d Strict rest for 4 -8 weeks Leash exercise 4 6 weeks Slow upgrading of exercise over next 8 weeks 10 15min slow walk Routine medical therapy for 2 weeks using NSAIDs and chondroprotectives Fortnightly recheck for 1st month then monthly rechecks for 3 4 months Advantages of De Angelis: Uncomplicated procedure No expensive equipment required 85% dogs go well clinically Disadvantages of De angelis: Tibial thrust is not overcome, and anterior draw can occur Progression of DJD Infection is a possibility therefore use Vetafil Size constraints <25kg do well with this technique The Tibial plateau leveling Techniques consist of : Tibal plateau levelling osteotomy (TPLO), Tibial wedge ostectomy (TWO), Tibial wedge and advancement ostectomy (TWAO) and Tibial crest advancements. Initially used only to correct abnormal caudal slope of tibila plateau, now its used: If there are large dogs>28kg, Increased tibial slope of any size Severe DJD A wedge of bone is removed and the rest is reduced and fixed with DCP Post Operative Care Bandage 1 week to decrease seroma Not boisterous activity for 8 12 weeks Towel walk 2 weeks no splits Leash walk at 4 weeks Graded exercise Routine medical therapy Recheck radiographs at 8 weeks Monthly rechecks for 3 4montrhs Most walk before de angeles TWO/TPLO advantages Overcomes TT very effectively Faster return to weight bearing Better long term functions TWO/TPLO disadvantages Complicated procedure Expensive equipment Costly Anterior draw not neutralized, but not greatly significant with the outcome of the use of the leg, but can injure with instability before. What neurological signs could be associated with an intervertebral disc protrusion, at the level of T13 and L1 vertebrae in the dog? List the possible treatment options for such a case. Causes the most common neurological syndrome in digs. Typical sings are due to a focal compressive myelopathy and/or radiculopathy. Clinical presentation is variable and depends on Site or protrusion/extrusion Volume of the mass Dynamic consideration: acute high velocity vs chronic low velocity extrusions Clinical signs depend upon the location of the lesion, the type and the dynamic force of the rupture Stage I Pain - medical Stage II pain +/- mild paresis medical or surgical Stage III paresis - surgical Stage IV paralysis - surgical with deep pain no deep pain <48 hour no deep pain > 48 hour Neurological complications that may occur in order if increasing severity are proprioceptive defects, paresis, nonambulatory paresis, but voluntary motor function, plegia, loss of voluntary urination and loss of deep pain Neurological signs with intervertebral dis protrusion: Back pain, hindquarter paresis, splining of epaxial and abdominal muscles Altered proprioception, nocicption and reflexes (UMN if T3 L3 or LMN if L4 S3). Pelvic limb signs are usually bilateral but occassionaly unilateral Imparied urinary bladder function is common with non-ambulatory parparesis or paraplegia Damage to UMN tracts will result in a tense full bladder that is diffcult to express Damage to LMN will result in the bladder overstretching and edetrusor muscle atony. Bladder capacity and urine retention increase progressibely. The bladder is usually flaccid, exhibits overflow incontinence and is easy to express. Treatment maybe medical or surgical. Decisions on tx mb made according to the stage if IVDD Early decompression and mass removal are strongly recommended for the majority of dogs with paraperesis or paraplegia. Surgical therapy can be Fenestration, or decompresive procedures such as dorsal laminectomy or a hemilaminectomy. Hip dysplasia is thought to be a result of early hip laxity. Describe clinical and radiographic techniques that demonstrate this laxity. Vary according to the age of the animal, but two clinical groups are recgonised Young dogs from 3 8 months of age Mature dogs 4 5 years Dogs may show a sudden onset of uni or bilateral hindleg lameness or they may be unwilling to exercise, jump or climb stairs and they may have trouble getting up from a lying postion. Palpation of the hips as the animal walks may reveil laxity or a popping feeling Manipulation of the hips is usually resented, esp on extension. The suggen onself of C/s is thought to be assoc. with micro-fractures of the acetabular rim as the pressure of rhte dipplaced femoral head overloads this area. Olderdogs show all the classical signs of degenerative osteoarthritis. Signs maybe uni or bilateral with either an insidious or a sudden onset, usually following vigorous exercise, prolonged rest or cold weather. The joint may have a reduced range of mvvt. Muscle atrophy is apparent, and the greater trochanter seems more prominent. Pain and crepitus may be evident on manipulation of the hips. The shoulders and thorax appear well developed to to compensatory muscular hypertrophy. Dx: based on hs and clinical signs and confirmed by observation, palpation, manipulation and radiography. Joint laxity checked for by the hip lift and the ortolani tests. Ortolani Test lateral or dorsal recumbency. Femur at a right angle to the pelvis, hand pressure is applied on the flexed stifle up the femoral shaft. In an unstable hip this will cause dorsal subluxation of th3e hip joint. The pressure is sustained while the hiop is slowly abducted. At some point a clunk or click will be heard and felt as the subluxated hip is reduce. This is called the angle of reduction. The pressure is sustained while the hp joint gradually adducted brought back to the startion position. A click will again be felt as the hip subluxates (Barlow sign) and this is called the angel of subluxatioh. These angels may have significance in evaluating patients for triple pelvic osteotomy surgery. Extension, flexion rotation and particularly abduction of the oin are used to evaluate the amount of joint stiffness. The std view for radiographic evaluation fot he hiyops is the ventro-dorsal hip extended projection, with the hind legs extended and parallel. Ensuyring that the whole body is straight should prevent rotation of the pelvis. The presence of new bone formation, the shape of the femoral head and the acetabulum aare examed for congruency of the articular surfaces. The dorsal rim of the acetabulum should be intersect the epiphyseal scar of the proximal femur about 2/3 1/3 of the distance from its lateral edge. Rotation of the pelvis will give a false impression of the acetabulsar depth. The side showing more of the iliac wing laterally will show a reduction of the acetabular depth and visa versa. PennHip scheme three views are taken 1 standard hip extended view for correlation purposes ventrodorsal viw of the pelis with the hiops flexed into a weight bearing position the same projection as #2, but with a special plexiglas rod device placed between the femurs wich acts as a fulcrum. This enables a distraction force to be exerted on the hip joints. A distraction index is calculated, which gives a measurement of hiplaxity. What is a rule that you can use to determine if a boine foetus in posterior presentation, normal position and posture, can safely be delivered vaginally by traction? Either longitudinal or transverse the foetuss orientation is either cranial or caudal in longitudinal presentation and dorsal or ventral in the transverse presentation Position is in relation of the dorsum of the foetus to the quadrants of the maternal pelvis. These quadrants are the sacrum, right iliu,, pubis and left ilium Posture is in relation of the foetal extremities to its own body. Edxtremities maybe flexed, extended or retained. Retention can be to the right left above or below the foetus. Delivery by traction: guideline sfor vaginal delivery Cranial presentation: if one person on leach leg can pull the fetlocks 10 15 cm beyond the vulva, the points of the shoulders will pass the maternal iliac shafts and the calf can be delivered vaginally. Caudal presentation: if one person on each leg can pull and make the hocks appear at the vulva the greater trochanters will pass the iliac shafts and the cal can be delivered vaginally. After delivering a calf by foetotomy, briefly describe your available options when a full-thickness tear in the ventral uterine wall is deteced in the post-delivery examination. Abdominal surgery left flank paramedian or middling, or iatrogenic uterine prolapse. Preop ab and post op oxytocin. Guarded to poor prognosis Outline events leading to the development and maintenance of pyometron in the cow where Trichmoniasis is not involved. Mainly a postpartum condition Dystocia or RFM Increase locial duration Postpartum ovulation at 16 18 d Cl formation and progesterone production Closure of cervic Severe endometrial damage Reduced endogenous Pg CL persistence Describe the medical tx of a prepucial prolapse prior to attempting surgery. Presurgical conservcative tx is usually necessary to reduce swelling and to improve the condition of the tissue. Using a bull sling to reduce venteal oedema is v. successful. Prior to surgery fibrosis and oedema are reduced to a minimal level, decreasing the risk of postoperative infection and failure. Feed is withheld from the bull 24 hours prior to surgery. Surgery is performed with the bull in right-lateral recumbency, either under general anesthesia or with a combo of xylazine sedation and local analgesia. The surgical area is prepared for aseptic surgery in a routine mater. Compare and contrast the paramedial and left flank caesarean section in the bovine. Your discussion should include: Indications Preparation for surgery Surgical approach and technique (describe one in detail and then indicate how the other one varies) 2003 Briefly describe the pathogenesis of prolapsed vagina in the bovine. Occurs mid to late gestation, due to high levels of oestrogens which causes laxisitiy of the ligaments and progressive movement of the vaginal to the outside, also bulls with large sheaths have been thought, but not proven to be a contributor. There is the view that breed disposition, heritability, inherited aspeced and in increase of foetal size due to abdominal pressure. You have just completed vaginal delivery of a calf by traction aned commenced cleaning your gear when you turn around to notice the uterus has prolapsed. In point form outline your tx of the prolapsed uterus. Isolater for protection Clean and protect with moist towels Frob leg position if recumband Standing elevate uterus above vula Clean and check for tears Trin placenta if still present Epidural Commence adjacent to the vulva Use frim kneeding action Push cranially and ventrally using fist and arm Infuse up to around 10 L of warm saline to evert uterus Siphon off excess saline Inject 50 IV oxytocin Im Penicillin Im Consider Ca borogluconate Intrauterine oxytetracycline 2 gm minimum Consider Bunher suture Outline events leading to the development and maintenance of pyometron in the bovine where Trichomoniasis is not involved. Due to chronic purulent metirits. Mainly a post partum condition. Dystocia or Retained FM increase lochial duration, postpartum ovulation at 16 18 days and Cl formation oand progesterone production. The cervix closed, endometrial damage occurs. There is a decrease in endogenous Prostaglandin and a pe3rsistent CL. Corticostroids are an effective tx for foetal mummification in the bovine. False tx with prostaglandin. They stimulate contractility fot eh uterine and other smooth muscels and have the ability to lower blood pressure, regulate acid secreation of the stomach, regulate body temperature and platelet aggregation and control inflammation and vascular permeability. Describe the surgical technique that you would use to correct a Grade II medial patella luxation in a small breed dog. Grade II IV no one surgical tech is adequate for correction of all grades of patella luxation The aims of the surgical therapy are to anatomically and functionally re-align the stifle improve limb function relieve pain prevent further skeletal deformity Surgical therapy involve soft tissue reconstruction bony reconstruction Surgery is done in a stepwise manner Evaluation of patella position and tracking is performed after each corrective procedure Additional procedures are performed as necessary Soft tissue reconstruction involves the items below and is usually adjunct to all surgical repairs, but can be the sole procedure in very young animals Lateral joint capsule and fascia lata imbrication Tightening joint capsule and fascia on lateral side helps prevent patella slipping medially Anti-rotational sutures Can be used solely in young puppies Adjunct in other dogs Medial releasing desmotomy Grade III and IV only Bone reconstruction involves Sulcoplasty Not in current use Chondroplasty Dogs less than 6 mot old Preserves articular cartilage Cartilage only is elevated from subchondral bone Bone is removed beneath cartilage flat to deepen sulcus Tibial tuberosity translocation Required in most cases of Grade II IV aligns insertion of quadricpes mm with sulcus Rectus femorus transfer Extreme Genu Varum Femoral bowing Staffies Aligns origin of quadriceps mm with anterior femur and sulcus Corrective osteotomy of femur/tibia Extreme cases of bone deformity only Poorer prognosis due to the extremem nature of the deformity Discuss factors that must be considered when selecting a method of cruciate repair in a dog. Acute sudden onset with no previous hs of lameness Chronic lameness for weeks to months, intermittent or constant Acute on chronic chronic lameness with an acute exacerbation The orthopaedic examiniation Lameness Pain on palpation and manipulation Decreased range of motion Joint effusion Periarticular thickening Anterior drawer sign Tibial thurst Meniscal click Muscle atrophy Types of ACL rupture Partial or incomplete Complete Avulsion Immature dogs and body fragements Conservative tx Small dog <5kg Rest for 6 8 weeks Routine medical therapy NSAIDA Chondroportective agents Surgical treatment Primary repair Young immature dogs Intracapsular stabilisation Fascial graft Medium to large breeds and acute injuries only Higher post op morbidity Outcome dependent on case suitability Post op care Currently not popular Extracapsular stabilisation Lateral stabilisation technique (de Angelis) Most common Mimics direction of ACL Relatively uncomplicated No expensive equipment required 85% dogs go well but does not overcome TT and Anterior draw can occur DJD progresses and really only used in small breeds <25kg Tibial osteotomy (TPLO, TWO) TPLO initaly used only to correct abnormal caudal slope of tibial plateau Now also indicated for large dogs, severe DJD Overcomes TT very well Faster return to wt bearing Better long term fctn But is a complicated procedure Expensive equipment Costly and Anterior draw is not neutralised Fibula head transposition Decision based on Tibial slope Size of the dog Degree of degenerative joint disease Cost and owner/dog compliance Paralumbar,distal paravertebral block ensures good analgesia of the related tissue structures, including the peritoneum. List five main indications for a flank paparotomy in the cow. Exdploratory lap, rumenotomy, c-section, intestional obstruction, reticular omasal opeing, abmosal displacement, LDA , RDA, Foreign body, SI intussecption RHS and LI torsion, visceral manipulation, organ biopsy, gynaecological/reproductive, research applications On planning a flank laprotomy, which organs would best be approached via a right flank incision Liver Kidneys Omentum Deudenum Colon Uterus but generally from the left hand side so the rumen keeps everything in. Small intestine Abomasum Left hand side Lateral wall/medial wall rumen Reticulum cranially Kidneys dorsally Gravid uterus ventrally LDA laterally On performing a rumenotomy, name the layers in order of wound closure Rumen wall Peritoneum Internal oblique External oblique Skin Which suture technique would be suitale for closure of the rumen wall. Name a suitable suture material for the procedure Inverting continuous, absorbable List four surgical techniques used to correct displaced abomasums in the dairy cow, suing appropriate terminology. Right paralumbar fossa omentopexy Left paralumbar fossa abomasopexy Right paramedian abomasopexy Closed suture + bar suture techniques During penile transection surgery of a feed lot steer, after isolating the vertical part of the penis between the adductor muscles, the urethra would lie: Describe the differential diagnosis and diagnostic processes you would consider in a 7 year old Doberman dog showing posterior limb ataxian and upper motor neurone signs to the hind legs. Dictated by site of CCS ventral, dorsal, multiple or single site Nature and static dynamic or both DX is based on signalment history and physical examination Confirmation of dx is made radiographicaloly, lateral and VD views narrowing, wedgin or collapse if IVD space, Narrowing ofr fogging of IV foramena, presence of califiied material in spainal canal. Oblique views may highlight lateral extrusions. Myelography confirms the site of compression and elucidates multiple sites if present. Decompression, stabilistation or both Vertebral tipping Ligamentum flavum Hourglass compression Cervical verterbral instability Chronic Intevertebral disease Intervetebral disc disease Cervical disc disease What surgical procedure may be undertaken to correct the conditions you mention Ventral compression Dorsal laminectomy Decompression stabilistation Fenstration Ventral slot Describe your diagnostic approach to OD of the humeral head. Large gian breed males, 4 10 months, progressive lameness uni or bilateral worse with exercise or after rest, examin both legs, physical exam, decrease in range of motion and increase pain on manipulation, manipulation exacerbates lameness, mild muscle atrophy, joint effusion, +/- creptation. Imaging, radiograph affected contralater M/L and Cr/Cd views, radiolucent defectes +/- OA ostiocontritis, Arthograp;hy, CT or MRI List in poiht form the surgical tx options for the 3 specific conditions comprising canine elbow dysplasia. Ununited anconeal process Fragmented medial coronoid process Osteochondritis desecans medial humeral condyl Excision of VAP Lag crew fixation Dynamic ulna osteotomy Remove fragmented coronoid process Cow ulna osteotomy Dynamic ulna osteomy Outline the predisposing factors for canine elbow dysplasia Young large breed rapidly growing males more than females, breed disposition, environmental factors, trauma physiological or salterharris fractures, or nutritional with increased energy or excess Ca. 2002 in the bovine, what are the natural mechanisms by which foetal membranes are removed during wstage three of parturition. Maternal crypt epithelium flattens, increase bacterial and leucocyte activity with release of membranes, hylinisation of blood vessels, rapid exsanguation and casoconstriction of foetral side, shrinkage of foetal placental villin, persitstent uterine contractions 72 hours and gravitational pull. Describe the normal characteristics of lochia in the bovine. Lochia albia the final vaginal discharge after partuition, when the amout of blood is decreased and the leukocytes are increas A Hereford calf delivered after a protracted dystocial has yellow staing visible particularly on the areas with white hair. What is the most likely due to and what does it indicated? Jaundice? With reference to the treatment of bovine dystocia, assuming the calf is dead, under what circumstances may a foetotomy be contraindicated as the means of delivery. Birth cananl too narrow Severly dry Uterus too tense Describet eh mechanism by which oestrogen exerts physical changes to the cow during the last week of gestation. List physical changest aht occur to the pelvis, cervix and vulva in the last week of gestation that are attributable to oestrogen. Vaginal prolapse with long term exposure, because of oestrogen high levels caus laxisity of ligaments and progressive movement of vagina to outside. Cervical prolapse depends on how much comes out as oestrogen assists with partuition Describe the surgical tx for ablation of the eye in a Hereford cow with severe squamous cell carcinoma of the limbus. Include pre-perative assessment and preparation, anaesthesia, the surgical technique, post-operative care and advice to the owner. Pre-operative assessment Indicated for progressed neoplasia Septic panopthalmitis Severe trauma beyond repair Severe trauma with loss of globe contents The common indications are squamous cell carcinoma of the upper ahnd lowere eyelids, third eyelid, cornea or any combo that is too extensive to be removed by other, less radical surgery such as v-plasty of third eyelid, H plasties or superficial keratectomies Preparation The should be wearing a halter and adequately restrained in a crush with its head secured to one side Routine skin prepping, prior to admin the retrobulbar block, the surgeon clips the hari around the animals eyes. If there are large amounts of necrotic neoplastic tissue, then some may be trimmed prior to the surgical scrub Pre-operative antibiotic tx will deliver medicated blood to the areal of the cavity, where a blood clot will from. Anaesthesia Local anesthesia is administered by infiltration of the retrobulbar tissues Petersons block or the four-point retrobulbar block is performed by injecting through the eyelids, both dorsally and ventrally and at the medial and lateral canthi A slightly curved 8 10cm 18 gauge needle is directed to the apex of the orbit where the nerve emerges from the foramen orbitorotundum About 40ml of local anesthetic are injected, divided into 10 ml per site. Exophalmos, corneal anaesthesia and mydriasis indicate a satisfactory retrobulbar block Peri-orbital tissues are infiltrated with an additional +/- 40ml of local anesthetic to desensitise the eye lids. Surgical Technique The patients eyelids are grasped with towel clamps and closed Or alternatively, suture the eyelids together and leave suture ends log Both of which can be used to put traction on the eye A transpalpebral incision is made around the orbit, leaving as much tissue as possible The incision is @1cm from the margin of the eyelid. The ventral incision and subsequent dissection are done first Sharp or blunt dissection is used for 360 ( degree around the orbit continuing downt eh caudal aspect of the orbit, but avoiding entrance through the palpebral conjunctivia All muscles, adipose tissue, the lacrimal gand and fascia are removed along with the eyelids and eyeball When the optic stalk and its blood supply are reached a pair of right angled forceps grasp the stalk, which is then severed distally Closure consists of a layer of simple interrupted sutures, or cruciate sutures in the skin using synthetic nonabsorable suture material Polymerized caprolactam (Vetafil) is used Post-operative care Sutures are removed 2 3 weeks postoperativlely. If infection is present, some of the skin sutures should be removed to permit drainage. Some surgeons prefer to pack the eye with sterile gauze to control haemorrhage and to remove the gauze a day or so after haemorrhage has stopped Generally this is not necessary because a tight seal with a skin suture allows pressure to build up within the orbit and to creat haemostasis thorugha tamponade effect Packing is indicated in cases of massive, uncontrollable haemorrhage. AB are indicated is sepsis is present. If dehiscence occurs, granulation tissue will generally fill the would satisfactorily. If healing id delayed, there maybe a recurrence of the neoplastic porcess Advice Much haemorrhage occurs at the time of surgery and it may alarm the inedperienced surgeon. If the surgery progresses quickly, bloos loss will be minimal. For this reason, some surgeons prefer a simple continuous pattern for closure. Discuss the surgical options for the tx of hip dysplasia in the dog Hip dysplasia a number of surgical techniques are available . Some are designed to improve the hoint congrucency and reduce the hip laxity and these are more appropriate in younger animals. Otherese are designed to relive pain. The following procedures may be indicated for dogs less than 12 months of age: Dogs less than 12 mo Triple pelvic osteotomy Objective to improve hip joint congruency and to eliminate dynamic joint laxity Can arrest the progressive aspects of hip dysplasia and provide a life free from pain and lameness. Primarily indicated whre there is excessive hop hoint laxity, w/o mjr changes to the structure of the femoral head and acetabulum Usually performed between 5 10 mo The hiop should be stable and femoral head retained w/in the acetabulum when the hip is abducted to 45( or less Contraindications include degenearative jt disease, loss of acetabular rim and severe anteversion. The operation is designed to rotate the acetabulum outwards by a measured amount giving more dorsal cover to the femoral head The amount of rotation is determined using the Ortolani test Surgery is contra-indicated if the angle of reduction is less than 20( or more than 45( Proximal femoral varisation Indicated primarioly in dogs with signs of hip pain, a newar normal acetabulum and an increase in the femoral head and neck inclination angle of 155( or more Best performed before changes in the articular cartilage are advanced Contraindications are a shallow acetabulum and aedvanced DJD The object of surgery is to reduce the femoral neck angle to normal (135() and to reduce the anteversion angle This places the femoral head deeper into the acetabulum thereby re-distributin the weight bearing over a greater area of articular cartilage Stress on the surrounding sof-tissue is alos relieved. DARthroplasty Purpose is to re-create or suppor the dorsal acetabular rim with bone graft harvested from the ipsilateral iliac crest Indicated with severe acetabular dysplasia and subluxation Juvenmile pubic symphysiodesis Aims to prematurely close the pubic symphysis Fusion is created using electrocautery to destroy the pubic growth cartilage Upto 50( rotation can be achieved. This causes some narrowing of the pelvic canal Have to older than 16 weeks at time of surgery As clinical signs are rare, palpation and potential candidates Mature dogs Pectinectomy Object of operatiooon is to relieve the adductor contracture associated with sub-luxation of the hip and to reduce the forces, which tend to push the femoral head dorsally out of the acetabulum. The beneficial effects are inconsistend and variable Dorsal Acetabulary Neurectomy Aims to sever the fine branches of the nerves that run in the periosteum that supply the dorsal joint capsule and the origin of the recturs femoris muscle. The indication for this procedure is dogs with hip pain Most effective in mature dogs with moderate DJD. Does not halt the progression of the DJD Excision arthropolasty Indicated for severe osteoarthritis, intractable joint pain and where the integrity of the hip joint has been irreparable damaged, chronic dystrophy, ischaemic necrosis of femoral head, fractures of femoral head/neck, acetabular fractures, dip dysplasia and DJD. Non-reversable, alsvage operation Aftercare very important physiotherapy to ensure a rapid formation of a false joint with a good range of motion NSAIDA are give to encourage early limb use Pain relief for 28 d Lead exercise started immediatel, swimming hill climbing or walking in sand/h2o Total hip replacement Main indication is in a mature, large breed dog with intractable hip pain and no othe rlcinical probs Contra-indications include a clinically sound dysplastic dog. Doges with a neurological dysfunction. Dogs with systemic disease, bacterial skin disease, active infection anywhaere in the body or neoplasia. Write short notes on the following: Osteochondritis dissecans in the dog Osteochnodrosis is a result of a disturbance in endochondral ossification of epiphyseal cartilage in rapidly growing animals resulting in the retention of peiphyseal cartilage If osteochondrosis results in a dissecting flap of articular cartilage with inflammatory joint changes, it is termed osteochondritis dissecans Because the necrotic cartilage is weakeer than normal tissue, it is highly vunerable to trauma If a larger enough area of necrotic cartilage forms and sufficient trauma is infliced a horizontal crack/cleft may form. If the trauma is continued, it may crack gertically, through the articular surface allowing synovial fluid to bathe the deep layers of degenerating cartilage leading to synovitis, joint effusion and clinical signs of lameness If there are no further stress, then the leasion may be able to heal With further stress, the crack becomes circumferential, formint a non-healing, movable flap that continues to stimulate synovitis until removed. The flap may remain attached or migrate Can vascularise and udergo endochondral ossification There is often a kiss lesion on the articular surface touching the flap It may occur in the shoulder, stifle, hock, elbow and vertebral articular facets Shoulder is the most common DX large, male 4-10mothn, with progressive lameness of variying severity, unior bilateral, worse with exercise or after rest Physical Reduced ROM, pain in extremes of manipulation, manipulation exacerbates lameness, mild muscle atrophy, joint effusion, mb crepitation Imaging affected join and the contralateral joint: M/L and Cr/Cd views, radiolucent defect my seen, can use CT or MRI TX OA will progress in all cases despite appropritate tx If recognised early <6mo may respond to conservative th, Dogs remaining lame after 6.5 months may benefit from surgery Older with significant Oa may benefit Conservative NSAIDA< glucosamine, chondroptotetive, cartrophin, modified exercise, restrict and confine for 4 6 wkkes, reintroduce 5 10 1 2x/d leash until sore then bring back down until confortable Surgical TX remove the flap or jt mous and loss cartilage , abrasion arthroplasty, forage A four-year-old Dachshund appears to have a compressive spinal lesion at the level of T13 L1 intervetebral dis space What clinical signs may this dog show? Back pain in the hindquarters, Paresis Splinting of apexial muscles Decreased proprioception, Reduced reflexes Bilateral mb uni What is the most likely cause of this compression Physiological, anatomical How would you confirm dx Plain contrast radiographs, surgical finding, What are you options for tx? 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